Australian Institute of Sport, Leverier Street, Bruce, Australia Capital Territory 2617, Australia.
J Athl Train. 2012 Nov-Dec;47(6):627-34. doi: 10.4085/1062-6050-47.6.12.
CONTEXT: Individuals with and without functional ankle instability have been tested for deficits in lower limb proprioception with varied results. OBJECTIVE: To determine whether a new protocol for testing participants' joint position sense during stepping is reliable and can detect differences between participants with unstable and stable ankles. DESIGN: Descriptive laboratory study. SETTING: University clinical laboratory. PATIENTS OR OTHER PARTICIPANTS: Sample of convenience involving 21 young adult university students and staff. Ankle stability was categorized by score on the Cumberland Ankle Instability Tool; 13 had functional ankle instability, 8 had healthy ankles. INTERVENTION(S): Test-retest of ankle joint position sense when stepping onto and across the Active Movement Extent Discrimination Apparatus twice, separated by an interim test, standing still on the apparatus and moving only 1 ankle into inversion. MAIN OUTCOME MEASURE(S): Difference in scores between groups with stable and unstable ankles and between test repeats. RESULTS: Participants with unstable ankles were worse at differentiating between inversion angles underfoot in both testing protocols. On repeated testing with the stepping protocol, performance of the group with unstable ankles was improved (Cohen d = 1.06, P = .006), whereas scores in the stable ankle group did not change in the second test (Cohen d = 0.04, P = .899). Despite this improvement, the unstable group remained worse at differentiating inversion angles on the stepping retest (Cohen d = 0.99, P = .020). CONCLUSIONS: The deficits on proprioceptive tests shown by individuals with functional ankle instability improved with repeated exposure to the test situation. The learning effect may be the result of systematic exposure to ankle-angle variation that led to movement-specific learning or increased confidence when stepping across the apparatus.
背景:有和没有功能性踝关节不稳定的个体已经接受了下肢本体感觉缺陷的测试,但结果各不相同。
目的:确定一种新的测试参与者在踏步行走时关节位置感的方案是否可靠,并且能够检测到不稳定和稳定踝关节参与者之间的差异。
设计:描述性实验室研究。
设置:大学临床实验室。
患者或其他参与者:方便样本包括 21 名年轻成年大学生和工作人员。踝关节稳定性通过 Cumberland 踝关节不稳定工具评分进行分类;13 人有功能性踝关节不稳定,8 人有健康的踝关节。
干预措施:两次踏步行走时踝关节位置觉的测试-重测,中间间隔一次测试,一次是在主动运动范围辨别器上站立不动,一次是仅移动一个脚踝进入内翻。
主要结果测量:稳定和不稳定踝关节组之间以及测试重复之间的分数差异。
结果:在两种测试方案中,不稳定踝关节的参与者在区分足底内翻角度方面表现更差。在踏步行走测试的重复测试中,不稳定踝关节组的表现有所改善(Cohen d = 1.06,P =.006),而稳定踝关节组在第二次测试中的分数没有变化(Cohen d = 0.04,P =.899)。尽管有这种改善,但不稳定组在踏步行走的重测中仍然更难区分内翻角度(Cohen d = 0.99,P =.020)。
结论:功能性踝关节不稳定个体在本体感觉测试中表现出的缺陷随着对测试情况的反复暴露而改善。学习效应可能是由于系统地暴露于踝关节角度变化,导致特定于运动的学习或在踏步行走时增加信心的结果。
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